Report (2nd Day)

Part of Health and Social Care Bill – in the House of Lords at 4:15 pm on 13 February 2012.

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Photo of Baroness Tyler of Enfield Baroness Tyler of Enfield Liberal Democrat 4:15, 13 February 2012

My Lords, I have a few remarks to make in support of the amendment, to which my name is attached. I shall be as brief as possible, because much of what I wanted to say has already been said. I pay tribute to the noble Baroness, Lady Masham, for arguing so eloquently for a statutorily enforceable duty of candour.

Having listened to the debate, I remain of the view that a provision in the Bill requiring provider contracts to include a duty of candour clause would be the best way forward and would send the clearest possible signal to the whole healthcare system about the need for openness. We have already heard that, as presently constructed, not all parts of the healthcare system would be covered by the contractual route. It would certainly send a much stronger message than merely relying on the contractual route. I do not see the two being mutually exclusive nor do I think that the principle of contractual freedom would be compromised by having a statutory duty of this sort. I believe that the duty of candour issue is of a different order from much of what else will appear in provisions in provider contracts. I also believe that it resonates very well with the public and would make a reality of what I think should be the most important underlying philosophy of the Bill, putting the patient first and the whole "No decision about me, without me" mantra.

Many noble Lords on these Benches feel very strongly on this issue. The key principle at stake is the right of patients, their families and their carers to know what has gone wrong with their care and treatment when, unfortunately, mistakes, including negligence, have been made. The statutory route would help to ensure consistency. We have already heard an interesting debate about the current lack of consistency. I very much agree with the noble Lord, Lord Harris, about the extent to which it would help to change the culture under which, currently, we know cover-ups have occurred, and make them much less likely to happen in the future. I recognise that a statutory duty alone will not achieve this; it will be a necessary but not a sufficient condition. The culture change that we have heard about will need role models among both clinicians and managers walking the walk, as well as training and support for staff, so that mistakes are acknowledged and, critically, lessons are learnt from the mistakes.

I know that my noble friend the Minister has taken a close interest in this issue and listened very sympathetically to the many representations that he received. I will listen very carefully to his remarks. I ask him to respond to two points in particular. First, if the Government are not minded to accept the statutory route at this juncture, will he undertake to review how the contractual duty is working, say, two years after it has come into effect, and consider again the statutory route if it is not proving to be effective? Secondly, will he report back to the House on the outcome of the recently closed consultation on the proposed duty of candour-notwithstanding, as we heard earlier, that it did not canvass views on other approaches; on whether the respondents thought the current arrangements would be adequate; on whether any other approaches were advocated; and on whether the Government intend to respond to the consultation?